One of the amusing things about working in a field that lets you interact with lots of different people is simply the stories that you come across. It is a well known adage that to be a writer, you must read, but I think that listening to other people's original stories is the way to go- you can't make stuff like this up.

For instance, a man with COPD and schizophrenia had a vision that if he smoked more, he would get healthier. He was later admitted to the ER with persistent cough and shortness of breath.

I've had several people who've had quick reentries to the hospital, which is always lousy. I had one lady that I evaluated in my first week of real work, and I remember her because I have an aunt with the same name. Most people, in meeting someone, would be at least mildly interested by that sort of anecdote, but this lady was thoroughly not amused. She needed to go to short term rehab since she'd had compression fractures and a pacemaker placed. 2 days after she got home from rehab, she fell at home and was even less happy to see me the second time around.

One of the downsides of working in acute care is that you see SO many people that it's hard to remember all the stories. The COTA has asked me once or twice about Mrs Soandso and I'll say 'can you refresh my memory?' Even with the response, 'yeah she's the frail little lady' I am usually struggling to remember. :)

An old story from my last job
that I never got around to writing up- 102 year old man was taking a mini-mental. I stick out my arm and say, "what's this on my wrist?" trying to get the response "watch." Instead he says, "oh that's some kind of growth. A mole. I big mole."

Recently evaluated a man w/ very advanced Alzheimer's and Parkinson's diseases. Per the chart review, he was basically wheelchair bound at home, largely nonverbal. Yet he somehow managed to 'take his family hostage' (though no weapon was mentioned) and he was brought to the ER in handcuffs. He was far too combatitive on day 1 for me to work with- throwing things and slapping at people. When I saw him on Day 2 he was a little more calm and the PT and I were able to get him into a chair, he was able to state his first and last names, but other than that we couldn't get him to follow any simple commands or tell us anything else. Later that day, while working with his roommate, he had decided to remove all his clothing and sheets and was requiring one person's complete attention to keep him from crawling out of the bed.

I do not envy our case managers and some of the placements that they have had to pursue recently. It is probably just 'the way things are' but it is very difficult having people with lousy home or medical situations come in, but not have rehab needs to qualify them to go elsewhere. I am trying not to get overly bummed out about that part, since I end up with a role in the drama. It also makes me think about what choices I would make in some of these situations, which is also a downer.

Though I have tried to hide it, my coworkers have figured it out (even quicker than last time) that I am a techie. We are encouraged to do point-of-care documentation and get notes in ASAP after an eval, so we all have little tablet laptops. I had been using mine as a regular laptop, but using a touchpad all day at work and then at home was making my wrists go into agony. So I resolved to figure out how to manipulate the tablet software (despite not having regular access to preferences) so that it would suit my needs, and for the most part, I have. I attempted a few evals Friday using this strategy to document in the room, and plan to hit it hard next week and make it work. Even with just trying it out on Friday, I got comments from a lot of excited coworkers who wanted to learn how to do it too. I may need to prepare a how-to guide since I don't mind sharing but definitely didn't get out on time on Friday. My current home computer is too newly purchased to talk about such things, but a tablet wouldn't be a horrible next purchase, however, the only thing I can see it really helping with is blog entries, so it's not really worth it as yet. Suppose I could eventually look into a tablet PDA, but the smaller screen would take a longer time to make work. I may also have a problem with mine at work since one section of the screen seems to have difficulty responding to my inputs... might have a dead zone.

Some of my coworkers are very resistant to the computer documentation, I am still surprised that a lot of the departments at the hospital do not do computer documentation. Everything was computerized at my last hospital, and this one is considerably larger, so I assumed they would be more 'with the times' so to speak. I remember way-back-when, first year OT school when potential research topics were brimming in my brain and I had thought of doing a project on whether therapists with computer documentation were faster, now I am glad I didn't since it is such a hot-button issue for some. Can of worms, though it would still be interesting to see the results. Anyone else use tablet computers for point-of-care documenting?

My current metro-reading strategy of reading a paragraph as the train slows down and stops at a station is going well. Since I can't seem to time the shuttle departure right (don't know if it's possible to) I am also picking up 10-20 minutes reading time there too. I am officially CAUGHT UP on all my OT Practices that had piled up during the transition time and actually eagerly awaiting new ones since I have time to read!! I am working on responses to some articles too, hopefully will be ready to post those soon.

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